November 2020 Imaging Case of the Month: Cause and Effect?

Abstract

No abstract available. Article truncated after 150 words. Clinical History: A 36 -year-old woman with Crohn’s disease and ulcerative colitis diagnosed approximately 1 year earlier, was initially treated with adalimumab, but later switched to prednisone and budesonide when subcutaneous nodules and migraines were attributed to this medication. Subsequently a flare of gastrointestinal symptoms prompted hospitalization with colonoscopy which showed severe pancolitis consistent with ulcerative colitis. One month following hospital discharge, the patient then presented to the Emergency Department with continued complaints of nausea, diarrhea, abdominal pain, intermittent fever (self-measured to 101º F), joint pain, and a pruritic rash all over her body. These symptoms had occurred following her hospitalization 2 months earlier. She also complained of 25 lbs. weight loss over the previous year. In addition to prednisone and budesonide, the patient’s medications included hydroxyzine, famotidine, vitamin C, and hydrocodone-acetaminophen. The patient denies allergies and did not smoke nor use drugs. Physical examination showed the patient to be …

Keywords

• crohn's disease
• immunosuppressed
• immunocompromised
• anti-tnf
• multiple pulmonary nodules
• mycobacterium
• mycobacterium tuberculosis
• diagnosis
• ct scan
• chest x-ray